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Hyperbilirubinemia: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Hyperbilirubinemia is also known as neonatal Hyperbilirubinemia, icterus or jaundice.

How is the treatment done?

Jaundice is a yellowish discoloration of the skin, mucous membranes and of the white of the eyes caused by elevated levels of the chemical bilirubin in the blood. Some degree of hyperbilirubinemia is very common right after birth, especially in premature babies. Treatment of hyperbilirubinemia in the newborn involves exposure of the skin to special lights and removal of serum from the blood and replacing with solutions free of bilirubin.

Jaundice in adults can be caused by a variety of medical conditions, some of which are serious and potentially life-threatening. Any adult who develops jaundice needs to undergo a comprehensive medical evaluation in order to determine its cause. Treatment of conjugated hyperbilirubinemia is dependent on the cause; it may include supportive or curative measures. The level of bilirubin (severity of jaundice) will determine the course of treatment. Tests to determine jaundice include physical exams, a laboratory test of a sample of your baby's blood, and a skin test with a device called a transcutaneous bilirubinometer, which measures the reflection of a special light shone through the skin.

Who is eligible for the treatment? (When is the treatment done?)

Neonatal Hyperbilirubinemia mostly disappears on its own within two or three weeks. Hyperbilirubinemia treatment depends on many factors, including its cause and the level of bilirubin. The goal is to keep the level of bilirubin from increasing to dangerous levels.

Light Therapy or Phototherapy:

Phototherapy may take several hours to begin working and is used throughout the day and night. Your baby may be placed under special lighting that emits light in the blue-green spectrum. The baby’s eyes must be protected. The light changes the shape and structure of bilirubin molecules in such a way that they can be excreted in the urine and stool. The light isn't an ultraviolet light, and a protective plastic shield filters out any ultraviolet light that may be emitted.

Exchange transfusion:

It is an emergency, life-saving procedure that is done to rapidly decrease bilirubin levels. The transfusion replaces an infant's blood with donated blood in an attempt to quickly lower bilirubin levels. Exchange transfusion may be performed in infants who have not responded to other treatments and who have signs of or are at significant neurologic risk of bilirubin toxicity.

Encourage feeding:

Providing adequate breast milk or formula is an important part of preventing and treating jaundice because it promotes elimination of the yellow pigment in stools and urine. You will know that your infant is getting enough milk or formula if s/he has at least six wet diapers per day, the color of the bowel movements changes from dark green to yellow, and s/he seems satisfied after feeding. In severe cases of jaundice, a blood transfusion or blood exchange may be needed.

Who is not eligible for the treatment?

Treatment of neonatal hyperbilirubinemia is usually based on the measurements of total serum bilirubin levels. It is generally recommended to start phototherapy at lower levels in low birth weight and very low birth weight infants than in term infants.

Are there any side effects?

Anyone who does not have jaundice cannot seek treatment for the same.

What are the post-treatment guidelines?

Phototherapy is safe, but it has some temporary side effects like skin allergy and loose stools. This is normal since this is the way the body removes the bilirubin. This will be temporary and should stop when treatment is completed. Contact your doctor if it persists after treatment is completed.

How long does it take to recover?

Infants with elevated bilirubin levels should be treated by a qualified doctor or nurse to safely reduce bilirubin levels and prevent the risk of brain damage. Parents and healthcare providers should not delay treatment for any reason. Take medications which prevent malaria before travelling to high-risk regions. Avoid medications and toxins which can cause hemolysis or directly damage the liver.

What is the price of the treatment in India?

Normal cases of hyperbilirubinemia recover in 20 days. In severe cases, depending on the treatment, a person needs minimum of 3 months to recover.

Are the results of the treatment permanent?

Phototherapy treatment in India, costs around Rs.10000 to Rs.15000.

What are the alternatives to the treatment?

The results are permanent. You have to take necessary steps to prevent hyperbilirubinemia, good hygiene and healthy food.

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